FeeBase
Log inGet started
Menu

Billing code 46045: Abscess drainageMedicare rate & RVUs

Reports operative drainage of a perirectal abscess under anesthesia when the collection requires surgical access beyond superficial bedside drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities127 Medicare services in 2024

Medicare pays $447.57 for 46045 nationally in a facility.

Medicare rate · 46045

Abscess drainage

Swap in your local Medicare rate.

Work RVUs
5.72
Total RVUs
13.40
Global days
090

National rate · 2026

$447.57

Facility setting, before claim adjustments.

See every locality for 46045 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 46045 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 46045 covers

A surgeon, commonly a colorectal or general surgeon, opens and drains a perirectal abscess in an operative setting with anesthesia. The service is used for a collection requiring operative access rather than drainage of a superficial perianal abscess. The operative note should identify the abscess location and document the drainage performed.

Select this code when the documented service is perirectal abscess drainage under anesthesia; use the abscess site and the procedure performed to distinguish it from nearby drainage codes. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 46045 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

46045 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$402.61
Alaska*Unavailable$538.31
ArizonaUnavailable$434.90
ArkansasUnavailable$397.04
AtlantaUnavailable$459.97
AustinUnavailable$455.65
BakersfieldUnavailable$455.50
Baltimore/Surr. CntysUnavailable$476.20
BeaumontUnavailable$425.28
BrazoriaUnavailable$437.98

46045 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
46045 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 46045 rate is calculated

Each of 46045’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 46045

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.72Practice expense 6.43Malpractice 1.25

13.4000 adjusted RVUs×$33.4009 conversion factor=$447.57

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 46045

46045 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46045

Abscess drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46045

Abscess drainage

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46045 without 51 · national facility

$447.57

Abscess drainage

46045-51 · Second procedure: 50%

$223.79

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

46045 compared with similar codes

Compare codes

46045 vs 46040 vs 46050 vs 46060: national Medicare rates

Swap in your local Medicare rate.

  • 46045
    Abscess drainage · 5.72 wRVU
    —
  • 46040
    Abscess drainage · 5.24 wRVU
    $630.27
  • 46050
    Perianal abscess drainage · 1.21 wRVU
    $267.21
  • 46060
    Abscess drainage · 6.21 wRVU
    —

How to choose

46040Abscess drainage
Both concern abscess drainage in the ischiorectal or perirectal region. Choose based on the precise service and abscess documented; 46045 specifically represents perirectal drainage under anesthesia.
46050Perianal abscess drainage
46050 is for a superficial perianal abscess. This code describes drainage of a perirectal abscess under anesthesia.
46060Abscess drainage
46060 includes treatment of an associated fistula by fistulectomy or fistulotomy along with abscess drainage. This code represents perirectal abscess drainage under anesthesia without that combined fistula procedure.

Codes related to 46045

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 46045
CodeHow it relatesNational office range
Used instead
46040Abscess drainageA nearby abscess-drainage option; choose according to the documented abscess and procedure.$552.30–$814.44
46050Perianal abscess drainageFor drainage of a superficial perianal abscess rather than a perirectal collection.$232.47–$364.63
46060Abscess drainageFor abscess drainage performed with fistulectomy or fistulotomy.No office rate

46045 billing questions

How is this distinguished from 46040?

Use 46045 for documented perirectal abscess drainage under anesthesia. Select 46040 when the documented drainage service and abscess type fit that code instead.

When is 46050 a better fit?

46050 describes drainage of a superficial perianal abscess. This code is for perirectal abscess drainage under anesthesia, not a superficial perianal collection.

Should 46060 be reported when a fistula is treated?

46060 describes abscess drainage performed with fistulectomy or fistulotomy. Review the operative report to determine whether that fistula procedure was performed rather than reporting drainage alone.

What documentation supports this code?

Document the perirectal location, the abscess drainage performed, and that the service was carried out under anesthesia. The operative report should distinguish the collection from a superficial perianal abscess.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, Medicare applies the standard multiple-procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 46045PPRRVU2026_Oct_nonQPP.csv, line 5,573 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 46045 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 46045 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →